1,721,149 research outputs found
Intrathoracic fluid changes from preconception to postpartum as measured by bio-impedance monitoring
No full textIntrathoracic impedance was remotely monitored from preconception to postpartum in a woman with an implantable cardioverter defibrillator. At 6 and 20 weeks, two significant changes were recorded, suggestive for thoracic fluid accumulation. After normal outcome, postpartum intrathoracic impedance returned to preconception values. The obtained results from this case report show that these measurements can be obtained with an implanted device. Current devices for measuring cardiac output by impedance technique allow evaluating thoracic fluid changes non-invasively. As such, non-invasive impedance monitoring may be a potential new method for continuous monitoring of maternal vascular changes during any time window between preconception and postpartum, to be assessed in a large cross sectional observational study.This report is part of the Limburg Clinical Research Program (LCRP) UHasselt-ZOL-Jessa, supported by the foundation Limburg Sterk Merk (LSM), Hasselt University, Ziekenhuis Oost-Limburg, and Jessa Hospital. No specific funding was provided for publication of this case report.Lanssens, D (reprint author), Ziekenhuis Oost Limburg, Dept Gynaecol, Schiepse Bos 6, Genk, Belgium.
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Midwives', Obstetricians', and Recently Delivered Mothers' Perceptions of Remote Monitoring for Prenatal Care: Retrospective Survey
No full textBackground: The Pregnancy Remote Monitoring (PREMOM) study enrolled pregnant women at increased risk of developing hypertensive disorders of pregnancy and investigated the effect of remote monitoring in addition to their prenatal follow-up. Objective: The objective of this study was to investigate the perceptions and experiences of remote monitoring among mothers, midwives, and obstetricians who participated in the PREMOM study. Methods: We developed specific questionnaires for the mothers, midwives, and obstetricians addressing 5 domains: (1) prior knowledge and experience of remote monitoring, (2) reactions to abnormal values, (3) privacy, (4) quality and patient safety, and (5) financial aspects. We also questioned the health care providers about which issues they considered important when implementing remote monitoring. We used a 5-point Likert scale to provide objective scores. It was possible to add free-text feedback at every question. Results: A total of 91 participants completed the questionnaires. The mothers, midwives, and obstetricians reported positive experiences and perceptions of remote monitoring, although most of them had no or little prior experience with this technology. They supported a further rollout of remote monitoring in Belgium. Nearly three-quarters of the mothers (34/47, 72%) did not report any problems with taking the measurements at the required times. Almost half of the mothers (19/47, 40%) wanted to be contacted within 3 to 12 hours after abnormal measurement values, preferably by telephone. Conclusions: Although most of midwives and obstetricians had no or very little experience with remote monitoring before enrolling in the PREMOM study, they reported, based on their one-year experience, that remote monitoring was an important component in the follow-up of high-risk pregnancies and would recommend it to their colleagues and pregnant patients.This study was part of the Limburg Clinical Research Program UHasselt-Ziekenhuis Oost-Limburg-Jessa, supported by the foundation Limburg Sterk Merk, the province of Limburg, the Flemish government, Hasselt University, Ziekenhuis Oost-Limburg, and Jessa Hospital
A Prenatal Remote Monitoring Program in Pregnancies Complicated with Gestational Hypertensive Disorders: What Are the Contributors to the Cost Savings?
No full textBackground:In 2015, we performed a cost analysis of a prenatal remote monitoring (RM) program compared with conventional care (CC) for women diagnosed with gestational hypertensive disorders (GHD).Introduction:We investigated where the cost savings were distributed by dividing our patient population into three subgroups, according to the gestational age (GA) at the time of delivery: (1) 37 weeks of GA.Materials and Methods:Health care costs were calculated from patient-specific hospital bills at Ziekenhuis Oost Limburg (Genk, Belgium) in 2015-2016. Cost comparisons were made from the perspectives of the Belgium national health care system (HCS), the National Institution for Insurance of Disease and Disability (RIZIV), and the costs to individual patients.Results:A total of 256 pregnant women were included, 80 (31.25%) of whom received RM and 176 (68.75%) of whom received CC. The greatest difference in costs between RM and CC was in the group that delivered before 34 weeks of GA, followed by the group who delivered after 37 weeks of GA, and then the group of women who delivered at 34-37 weeks of GA. Most of the cost savings were in neonatal care, for both the three separate study subgroups and the total study group.Discussion and Conclusion:Our data showed that RM is more cost-effective than CC for pregnant women with GHD. Further investigation of the effects of RM on the long-term economic and social costs is recommended, together with an analysis of the price that should be asked for RM services.We thank the obstetricians and midwives of the Department of Gynecology at the Ziekenhuis Oost-Limburg and the other hospitals participating in the PREMOM project (JESSA Ziekenhuis, Hasselt; Sint-Franciskusziekenhuis, Heusden-Zolder; Ziekenhuis Maas en Kempen, Bree; Mariaziekenhuis Noord-Limburg, Overpelt; Sint Trudo, Sint Truiden; and AZ Vesalius, Tongeren). We also like to thank the financial department of the Ziekenhuis Oost-Limburg (Genk, Belgium) for their assistance and support during this study.
This study is part of the Limburg Clinical Research Program (LCRP) UHasselt-ZOL-Jessa, supported by the Foundation Limburg Sterk Merk, the province of Limburg, the Flemish Government, Hasselt University, Ziekenhuis Oost-Limburg, and Jessa Hospital. This work was supported by Foundation Mustela (Laureate 2016)
Validation of a smartphone based photoplethysmographic beat detection algorithm for normal and ectopic complexes
No full textBackground: To date little or no smartphone apps exist to differentiate between a normal heart beat and a premature ectopic beat. Aim: To develop and validate a smartphone based acquisition and processing algorithm based on photopletyhsmographic (PPG) data collected in a controlled hospital environment. Methods: A smartphone camera application was developed to record PPG data in synchronization with a reference electrocardiogram. Subjects were recorded while undergoing an electrophysiological examination. The PPG data acquisition was validated on 28 volunteers with sinus rhythm. After signal analysis an algorithm was developed for detection of ectopic beats. To characterize arrhythmias, supraventricular extrasystoles were induced every 10, 5 or 3 beats after 500 ms by applying a pacing train to the right atrium. The coupling interval was also examined by altering the intermediary time by 400, 500 or 600 ms. Results: After signal conditioning, an accurate ectopic beat detection was obtained from the PPG signal. Premature atrial ectopic beats could be differentiated based on the interpeak distance at different coupling intervals. Conclusion: By acquiring a PPG signal with the camera, the smartphone is not only capable of determining a regular sinus rhythm, but it also has the power to identify ectopic beats
Detection of subclinical transient fluid accumulation during pregnancy in a patient with an implantable cardioverter defibrillator and OptiVol (R) fluid monitoring algorithm
No full textValidation of a smartphone based photoplethysmographic beat detection algorithm for normal and ectopic complexes
No full textBackground: To date little or no smartphone apps exist to differentiate between a normal heart beat and a premature ectopic beat. Aim: To develop and validate a smartphone based acquisition and processing algorithm based on photopletyhsmographic (PPG) data collected in a controlled hospital environment. Methods: A smartphone camera application was developed to record PPG data in synchronization with a reference electrocardiogram. Subjects were recorded while undergoing an electrophysiological examination. The PPG data acquisition was validated on 28 volunteers with sinus rhythm. After signal analysis an algorithm was developed for detection of ectopic beats. To characterize arrhythmias, supraventricular extrasystoles were induced every 10, 5 or 3 beats after 500 ms by applying a pacing train to the right atrium. The coupling interval was also examined by altering the intermediary time by 400, 500 or 600 ms. Results: After signal conditioning, an accurate ectopic beat detection was obtained from the PPG signal. Premature atrial ectopic beats could be differentiated based on the interpeak distance at different coupling intervals. Conclusion: By acquiring a PPG signal with the camera, the smartphone is not only capable of determining a regular sinus rhythm, but it also has the power to identify ectopic beats
EXERCISE-INDUCED INCREASE IN EFFECTIVE MITRAL VALVE AREA AFTER RESTRICTIVE MITRAL VALVE ANNULOPLASTY
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